I oppose racism. I let fear limit how I publicly expressed this though. I am embarrassed. I contributed to books about race but didn’t publicize them on social media because I was afraid of alienating patients. I have since updated my social media profiles, but the shame persists. However, as ashamed as I am of my fear, I have moved past it, and it’s time society does as well. Being ashamed of your past means you have grown.

As a PA student, I was on the receiving side of microaggressions because of my credential. There have been some slights since I graduated as well. However, what I endured during rotations due to my title pales in comparison to what I have read on twitter about race-based microaggressions. Dr. Samuel Kebede started a thread on Twitter sharing micro-aggressions he had experienced: being told by a white patient “I am setting an example because other Black people are lazy.” Being stopped by hospital security while a white classmate in front of him was let through without needing to show ID. Calling one Black student (whom the professor had never met) the name of another Black colleague (whom she had met) numerous times. Walking into an OR and two residents informing him the room had already been cleaned. A patient asking if he was there to empty the trash. Being told his English was very good for an African. Patients requesting, and being granted, a new white surgeon.

The incidences went on and on, and are truly too depressing and embarrassing to catalog completely. Sadly, I worry I may be have been guilty in the past of microaggressions of omission; specifically the time a patient said something racist about Indian doctors, while a student was present no less, and I, in shock, said nothing. I still think about how I let him get away with it, and vow to speak out in the future.

That is what we need to do now. We need to recognize when we misspoke or acted out of place, and we need to do much better. We need to create a new system of inclusion and support for one another. To do so, we need to be more than just not racist, it is time to be anti-racist. We need to eliminate as much racism and hate as we can from the world, even though as recent history has shown, it will not be easy, rather it will be painful. 

Some argue there is no place for medicine to speak out against racism. I strongly disagree. If we are to care for our patients, we must do everything we can to do, and speaking out for their rights is something we can and should do. Additionally, it is time to speak out for the next generation of clinicians, so a population of diverse students can learn in a positive environment, one free of race-based assumptions. I am not alone in this belief, the White Coats for Black Lives movement includes many others with similar goals.

There are those in medicine arguing that now is not the time for protests. That the COVID-19 virus is going to spread like wildfire because of them. More than 1,000 of my peers signed a letter speaking to the need to address the public health crisis of racism, as well as addressing concerns the pandemic presents. A summary of their recommendations for protesting during the pandemic are as follows:

• If you do go out, wear a mask, attempt to maintain 6 foot distance, stay with your close contacts as to not intermingle too much with new contacts. Provide others access to facemasks, eye protection, hand wash, etc. to help protect them. If you are sick, DO NOT GO OUT.
• Advocate law enforcement not to arrest peaceful protestors, and to not hold those that they do detain in confined space. Similar to protestors, law enforcement needs to use protective equipment, and maintain a safe distance.
• Law enforcement should avoid the use of teargas or other respiratory irritants which cause coughing.
• We must reject the message that face masks/protection are motivated by concealment; during the pandemic, they are vital safety measures.
• The above will not be perfect, so health systems need to brace for an increase in COVID-19 cases following these gatherings.

If anything, fear is driving force for the problems we face. I was afraid my patients would refuse to see me in clinic because I contributed to books advocating for minorities. Some of you may fear being too vocal will affect your jobs in medicine, the respect your patients show you. This mindset has held us back, in medicine, in society, too long. It is time to speak up, it is time for action. We should be afraid to not speak up. That being said, to fix racism inside medicine, we honestly need to fix racism in society. Now may feel like the wrong time for protests and speeches, but we have waited too long already. The time is now.

Sean practices rural medicine as a physician assistant in western Kansas. He enjoys writing not only online, but has contributed to anthologies with 2Leaf Press and authored Through the Eyes of a Young Physician Assistant. When the outdoors call, it is to go golfing, fishing, or hunting with his sons. He tweets at @SeanConroyPAc. Sean is a 2019-2020 Doximity Fellow.

Image: Alexander Baidin / shutterstock